Well-prepared for heart attacks

More people in Singapore are getting heart attacks in recent years, but fewer are dying because of them as Singapore has been improving its medical procedures to treat heart attack patients faster.

In 2016, only one in 12 people that suffered heart attacks died, half of what was recorded in 2007. This is attributed to better and quicker treatment for heart attack victims, which has cut the median door-to-balloon (DTB) time from 95 minutes to 55 minutes over the 10-year period. The DTB time refers to the time between the patient arriving at the hospital and receiving balloon angioplasty to unblock his or her blood vessel.

When handling victims of heart attacks, paramedics from the Singapore Civil Defence Force will perform on-site electrocardiograms to establish the amount of blockage in the arteries. The results are then transmitted to the hospital, to prepare for the arrival of the patient. Typically, the faster the arteries are unclogged, the better the recovery as more heart muscle is preserved.

Such improvements have allowed patients with the most serious cases of heart attack to be attended to far more promptly, decreasing their mortality rates. Only nine in 20 of such patients were treated within 90 minutes in 2007, but this number had risen to 19 in 20 by 2016. The average age of a heart attack patient also rose from 67.6 years to 69.3 years in that same period.

Men are known to be more susceptible to heart disease, as every two in three heart attack victims were men. In Singapore, half of all heart attack patients were diabetic, and almost half were smokers. Other risk factors include high blood pressure, high cholesterol levels and obesity. While these risk factors can be controlled or in the case of smoking, stopped, risks are still higher for people with such conditions even when the factors are well controlled.

“Control of risk factors, especially with cholesterol-lowering, significantly reduces the risk of cardiovascular events such as death and heart attacks, but does not eliminate it,” according to Professor Tan Huay Cheem, a professor of Medicine at NUS Medicine and director of the National University Heart Centre, Singapore (NUHCS).